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Practice topics Exam 1 > Infectious disease - TB and Hepatitis > Flashcards

Infectious disease - TB and Hepatitis Flashcards

1
Q

Infectious disease - definition

A

Clinically evident infection causing injury and clinical signs/symptoms

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2
Q

“communicable disease” definition

A

is one in which the pathogen may be transmitted from one person to another

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3
Q

Hepatitis is what

A

inflammation of the liver
most common cause of infectious hep in US is viral
significant amounts are unreported

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4
Q

Non-infectious hep aka

A

Nonviral

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5
Q

Non-infectious hep causes

A

Medication overdose - acetominophen, niacin
Toxins - carbon tetrachloride (freon)
Autoimmune disorder - multisystemic disease

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6
Q

Viral hepatitis description

A 
6 strains of viruses have been identified
3 of most common are 
- Hep A (infectious)
- Hep B (serum) 
- Hep C (non A, non B)
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7
Q

Hep A - chronic infection

A

NO - it does not have a chronic infection component to it

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8
Q

Hep B - chronic infection

A

YES

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9
Q

Hep C - chronic infection

A

YES

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10
Q

Hep A - how transmitted

A

feces, bile, blood, shellfish
ORAL - FECAL route of transmission
person to person contact

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11
Q

Hep A - incubation

A

30-45 days

Incubation means you are infected and can spread during this time

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12
Q

Hep A - onset

A

acute with fever

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13
Q

Hep A - contagious for how long

A

up to 3 months after onset of s/s

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14
Q

Hep A - prevention/treatment

A

Pre/post immunization

Hygiene

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15
Q

Hep A - mortality

A

Mortality rate is low - if do pass away, is likely due to something else going on

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16
Q

Hep B - how tranmitted

A

Blood, body fluids, contaminated needles

Often sexually transmitted

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17
Q

Hep B - incubation

A

60-180 days

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18
Q

Hep B - onset

A

insidious - often don’t know they are sick until months into the disease

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19
Q

Hep B - chronic

A

yes

up to 30% develop chronic hepatits

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20
Q

Hep B - prevention/treatment

A

pre-post immunization

interferon, antiviral meds

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21
Q

Hep B - mortality

A

1% develop fulminant hepatic failure with an 80% mortality rate!!!

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22
Q

Hep C - transmitted how

A

Most cases of transfusion hepatitis

Blood, infected needles

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23
Q

Hep C - Incubation

A

30-180 days

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24
Q

Hep C - onset

A

insidious

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25
Q

Hep C - chronic

A

Yes!

up to 50-80% develop chronic hepatitis

26
Q

Hep C - prevention/treatment

A

screening, modify risk bx

No immunizations for this!

27
Q

Clinical presentation - ranges from

A

absence of s/s to liver failure and then coma and death

28
Q

Clinical presentation - phase 1

A

incubation - hepatitis virus in stool

29
Q

Clinical presentation - phase 2

A

prodromal - when people usually seek doctor
Fatigue, anorexia, malaise, vomit, HA, cough, low fever, weight loss, abdominal pain
Often misdiagnosed with gastroenteritis!!!

30
Q

Clinical presentation - phase 3

A

Icteric (acute)

Jaundince, dark urine, discolored stool, hepatomegaly, tender liver, abdominal pain

31
Q

Clinical presentation - phase 4

A

recovery - resolution of jaundice, symptoms diminish, liver may stay enlarged
Liver will not shrink back to normal!

32
Q

Complication - Fulminant hepatitis is what

A

CLinical syndrome with necrosis of liver cells
jaundice, abdominal pain, anorexia, vomit are initial signs
ascites and GI bleed in later stages

33
Q

Complication - fulminant hepatitis - what is the outcome

A

necrosis of the liver is irreversible
up to 90% of patients die
need liver transplant!!!

34
Q

Cirrhosis is what

A

irreversible inflammation causing fibrosis

35
Q

Development of cirrhosis

A

multiple causes
liver hypertension occurs at end stage
often develops slowly but if toxins are involved it can progress quickly

36
Q

Cirrhosis - effect on other systems

A

Hormone effects
Metabolism effects
Portal hypertension effects

37
Q

Cirrhosis - effect on other systems - hormone

A

menstrual dysfunction
hair loss
spider angiomas
edema

38
Q

Cirrhosis - effect on other systems - metabolism

A 
jaundice
light colored stool
bleeding tendency
dark urine
hypoglycemia
39
Q

Cirrhosis - effect on other systems - portal hypertension effects

A 
Ascites in the abdomen
edema
anemia
leukopenia
internal varices
40
Q

Treatment summary for hepatitis

A

IMMUNIZATION for A and B
Supportive tx
Watch for complications

41
Q

Chronic hepatitis - goal of tx is to

A

reduce liver inflammation and scarring

42
Q

TB - timeline

A 
1865 - contagious
1882 - organism discovered
1884 - first sanatorium in US
1943 - drug discovered to tx (streptomycin)
1970 - sanatoriums closed
1980 - rise of TB cases (mid 1980s)
1993 - decline in TB
43
Q

TB - overtime what has happened

A

overall decline but recent increase in the drug resistant TB

higher rates in port states

44
Q

TB - demographics

A

most 24-63 yrs of age

M more than F

45
Q

TB - causative pathogen

A

In US majority are by mycobacterium tuberculosis

46
Q

TB - infectious process - how spread

A

it is spread through the air
infection occurs when susceptible person inhales droplet nuclei containing tubercle bacilli and the droplet nuclei reaches the alveoli in the lungs
Immune response can kill most bacilli, leading to formation of a granuloma

47
Q

Latent TB

A

Not active disease
Granuloma has been established
Immune response controlled the infection
Tests pos on the skin test (but they dont have disease and cant spread it)

48
Q

Active disease - TB

A

Can be soon after infection or years later
5% who are infected will develop the disease within 1-2 yrs of the infection
Another 5% will develop it sometime later
Inc rate in those with dec immune response (ex - those with HIV)

49
Q

TB infection vs. TB disease - for both of them

A

Tubercle bacilli in the body

Tubercle skin test usually positive

50
Q

TB infection vs. TB disease - chest x ray

A

infection - normal

disease - abnormal

51
Q

TB infection vs. TB disease - sputum smears and cultures

A

infection - negative

disease - positive

52
Q

TB infection vs. TB disease - symptoms

A

infection - none

disease - cough, fever, weight loss

53
Q

TB infection vs. TB disease - infectious

A

infection - not infectious

disease - often infectious before tx

54
Q

TB infection vs. TB disease - case of TB?

A

infection - no

disease - yes and should be reported

55
Q

TB classification system

A 
0 - no exposure, not infected 
1 - exposure yes, no evidence of infection
2- infection yes, no disease
3 - TB case, clinically active
4 - TB case, not clinically active 
5 - TB suspected
56
Q

Risk factors for TB infection

A 
Foreign born
Travel
Urban poor, homeless
Military personnel
Illicit drug use - injected
Health care workers
57
Q

Risk factors for TB disease

A 
HIV infection
Recent TB infection 
DM
Sillicosis
Prolonged corticosteroid use
Immunosuppresive therapy
Cancer
Severe kidney dsease
Intestinal conditions
Low body weight
58
Q

TB clinical manifestations

A

Cough with duration 3 weeks or more
Chest pain
Hemoptysis
Systemic s/s - fever, chills, night sweats, appetite loss, weight loss, easy fatigability

59
Q

TB - Extrapulmonary TB

A

common site - skeletal system - common is spine (Potts)

also now finding it in TMJ

60
Q

TB intervention

A

PREVENTION!
long term tx (3-12 months)
Multiple drugs
Directly observed therapy (DOT) preferred management strategy

61
Q

TB goals of tx

A

Cure pt, minimize death and disability from TB

Interrupt transmission to other people

62
Q

TB - drug therapy includes

A 
Multidrug! 
First line = 
- isoniazid (INH)
- Rifampin (RIF)
- Ethambutol

Now seeing Pyrazinamide (PZA) for the drug resistant strain of TB

Practice topics Exam 1 (15 decks)

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